MONTREAL — It’s been nearly 14 months since accused hospital fraudster Arthur Porter — who says he’s suffering from Stage IV lung cancer that has spread to his liver, abdomen and bones — was arrested in Panama and incarcerated in La Joya, a prison that is notorious for its unsanitary conditions.

During his imprisonment, Porter’s lawyer says his client has been denied medical treatment for his cancer, has not once been examined by a doctor and has not been allowed to undergo a medical-imaging scan to determine whether the “cannonball”-size tumours in his liver have grown or regressed.

In June 2013, days after he was jailed, two of Porter’s associates who are doctors said they had separately examined him months earlier and each told The Montreal Gazette that Porter had less than a year to live based on the advanced stage of his illness.

“Unfortunately, (the prognosis is) not good,” Duane Sands, a certified cardiothoracic surgeon who practises in the Bahamas, said in an interview on June 5, adding Porter’s tumours were as big as cannonballs.

“I think if we want to be optimistic, then a year is optimistic.”

Yet more than a year later, the former chief executive officer of the McGill University Health Centre is “holding up” according to his lawyer, Richard Bilonick, despite his lack of access to medical care.

Porter himself is aware the public might be skeptical as to whether he is truly suffering from metastatic lung cancer — given he is fighting extradition to Quebec to face criminal charges alleging he defrauded the MUHC of $22.5 million in the $1.3-billion superhospital construction contract. Porter’s family has addressed the issue in a statement released on his website, illegalinlajoya.com.

“The media continue to perpetuate false claims that (Porter) was ‘self-diagnosed,’ insinuating that he may not even be ill,” the statement says. “Although our family wishes that were the case, this is simply not true.”

With Porter’s consent, his family has released what it affirms are his medical records “together with a timeline to eliminate further speculation.” However, far from ending any speculation, those records have raised more questions as Porter — languishing in a filthy, humid prison cell — continues to defy the odds of survival of one of the deadliest, most aggressive forms of cancer.

Porter, a radiation oncologist, says he’s suffering from non-small cell lung cancer (NSCLC). There are three main types of NSCLC, and Porter says he’s afflicted with adenocarcinoma, a cancer that begins in the cells that line the alveoli (the tiny air sacs in the lungs where the exchange of oxygen and carbon dioxide takes place), according to the U.S. National Cancer Institute.

Porter, who is 58, said he learned he had Stage IV NSCLC in January 2013. That month, he noted he began five treatments of radiotherapy.

A 2006 study of 287 patients with Stage IV NSCLC who underwent radiotherapy found the median survival was eight to 10 months. In general, studies have estimated the overall chances of surviving that type and stage of cancer one year after diagnosis to be about 30%.

Porter did not only stick with radiotherapy. He said he followed up with two cycles of standard chemotherapy using the drugs Taxol and Carboplatin. In March 2013, a CT scan revealed Porter did not respond to those drugs.

That same month, Porter’s doctor, Karol Sikora, said a pathology report from London confirmed his type of cancer had the ALK mutation. That meant Porter was eligible to be treated with a promising new “biological” cancer drug, Crizotinib.

(Sikora was one of several doctors in Britain who had examined Lockerbie bomber Abdel Baset Megrahi in 2009, concluding he had three months left to live because of his terminal prostate cancer. Scottish authorities released Megrahi on compassionate grounds and he returned to a hero’s welcome in Lybia, where he lived another three years.)

The Gazette consulted several oncologists about Porter, but the doctors were reluctant to give an opinion on the record, having not examined him. Still, some MUHC physicians have viewed the medical-imaging scans Porter has posted on his website and they acknowledged privately those images do show advanced lung cancer.

Porter started Crizotinib in March 2013 and showed a “good response” in the liver and lymph nodes, Sikora said in a letter that is part of Porter’s medical records.

A 2013 study published in the New England Journal of Medicine found progression-free survival was more than twice as long in NSCLC patients treated with Crizotinib than those who underwent standard chemotherapy: 7.7 months vs. three months. But Crizotinib is by no means a cure.

As of October 2013, Porter was still receiving Crizotinib in jail sent from a cancer centre in Nassau. It’s not clear whether 16 months after taking Crizotinib, Porter is still on the drug.

Pfizer, which manufactures Crizotinib, recommends the capsule be taken orally “twice daily until disease progression or no longer tolerated by the patient.” Pfizer’s monograph on Crizotinib — sold under the brand name Xalkori — contains no information on patients who have been taking the drug longer than 11 months.

In a telephone interview from Panama on Thursday, Bilonick said he regularly hand-delivers medication to Porter in jail, but he didn’t know the names of the drugs.

Asked about the condition of Porter’s health, Bilonick responded:

“Well, he’s holding up. I bring him some medicines.”

Asked how Porter could defy the medical odds by surviving with such an aggressive form of cancer past a year in jail without medical attention, Bilonick replied:

“I don’t know. He must be a very smart guy, and also he knows what he’s doing about the medicine. How he has survived is irrelevant. What is relevant is that the people should be worried about his survival — and the Canadian government is doing nothing about it.”

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